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  • 1995-1999  (4)
  • Cardiomyoplasty  (2)
  • INFLAMMATORY BOWEL DISEASE  (2)
  • 1
    Digitale Medien
    Digitale Medien
    Springer
    Digestive diseases and sciences 43 (1998), S. 1356-1361 
    ISSN: 1573-2568
    Schlagwort(e): INFLAMMATORY BOWEL DISEASE ; THROMBOPHILIA ; COAGULATION ; ACTIVATED PROTEIN C ; RESISTANCE
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Thromboembolic events frequently complicate theclinical course of patients with inflammatory boweldisease (IBD). Hereditary thrombophilia may contributeto this tendency. Resistance to activated protein C is the most recently described thrombophilicstate and may account for up to 40% of patients withthrombophilia. Thirty-seven patients with IBD werestudied (mean age 44 years, range 18-82 years). Three patients had a history of thrombotic episodes.The 37 controls included 23 men and 17 women (mean age48 years, range 16-89 years). Disease activity wasassessed using the Harvey Bradshaw index for patients with Crohn's disease and the Truelove and Wittsgrading system for patients with ulcerative colitis.Levels of fibrinogen, antithrombin III (ATIII), proteinC, protein S, activated protein C resistance (APCR), and the presence of a lupusanticoagulant (LA) were determined. Median ATIII levelsin patients with IBD were significantly lower thancontrols (98% vs 106%, P = 0.007), while fibrinogen waselevated (4.2 vs 3.3 g/liter, P = 0.026) despitequiescent disease activity. LA was detected in 7/37patients in the IBD group compared to 0/37 controls.(χ2 = 5.68, P = 0.017). No significantdifference was observed in levels of inherited thrombophilic factorsand in particular APCR between IBD patients andcontrols. In conclusion, the presence of inheritedthrombophilic defects, in particular APCR, is uncommonin patients with IBD and does not merit routinescreening.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1573-2568
    Schlagwort(e): INFLAMMATORY BOWEL DISEASE ; ANTI-CARDIOLIPIN ANTIBODIES ; DEEP VENOUS THROMBOSIS
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Elevated levels of anti-cardiolipin antibodiesare associated with an increased risk for venous andarterial thrombosis. In patients with inflammatory boweldisease thrombosis is a well known complication. We determined the prevalence of elevatedanti-cardiolipin antibodies in 136 patients withinflammatory bowel disease compared with 136 healthycontrols and analyzed thromboembolic complications inpatients with increased anti-cardiolipin antibodylevels. Anti-cardiolipin antibody titers weresignificantly elevated in patients with Crohn's disease(5.7 units/ml) and ulcerative colitis (5.3 units/ml)compared to the control group (2.5 units/ml). We foundno correlation between disease activity andanti-cardiolipin antibody levels. Seven patients haddeep venous thrombosis in their history, in three ofthem this was complicated by pulmonary embolism. In onlytwo of the seven patients with deep venous thrombosiswere anti-cardiolipin antibody levels increased. Inconclusion, anti-cardiolipin antibody titers were significantly increased in patients withinflammatory bowel disease. Elevated anti-cardiolipinantibody levels appear to play no role in thepathogenesis of thromboembolic events in patients withinflammatory bowel disease.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    ISSN: 1573-9686
    Schlagwort(e): Elastance ; Stroke volume ; Model ; Cardiomyoplasty
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Technik allgemein
    Notizen: Abstract Dynamic cardiomyoplasty (DCM) is an emerging surgical procedure for heart failure in which the patient's latissimus dorsi (LD) muscle is wrapped around the heart and stimulated to contract in synchrony with the heartbeat as a cardiac assist measure. A 6 week training protocol of progressive electrical stimulation renders the normally fatigueable skeletal muscle fatigue-resistant and suitable for chronic stimulation. To date, over 500 procedures have been performed in worldwide clinical trials. Investigators typically report symptomatic improvement and modest hemodynamic improvement in patients. Controversy exists regarding the exact mechanism of DCM. To test the hypothesis that DCM augments cardiac stroke volume through improvement in systolic function, we formulated an engineering model of dynamic cardiomyoplasty to predict stroke volume. The heart and the LD were modeled as nested (series) elastance chambers, and the vasculature was represented by a two-element Windkessel model. Using five healthy goats, we verified model predictions of stroke volume for both stimulator ON beats (y=1.00x−0.08, r=0.87, p 〈 0.0001) and OFF beats (y=1.01x+1.06, r=0.91, p 〈 0.0001), where x and y are the measured and predicted stroke volumes, respectively. The model confirms that using untrained latissimus dorsi applied to the normal myocardium produces only moderate increases in stroke volume and suggests that future research should focus on increasing LD strength after training.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    ISSN: 1573-9686
    Schlagwort(e): Clinical cardiomyoplasty ; Nomogram ; Muscle transformation ; Model ; Cardiomyoplasty ; Applications
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Technik allgemein
    Notizen: Abstract Previously, a modification to the Sunagawa engineering model for the isolated left ventricle and arterial system was proposed and validated for dynamic cardiomyoplasty in an acute goat preparation. To test the hypothesis that this model may be applied to the clinical scenario in cardiomyoplasty patients, we predicted human stroke volume using the model with human clinical data from the literature. Predicted stroke volume correlated well with published stroke volume in patients who have had the dynamic cardiomyoplasty procedure. These results suggest that the modest hemodynamic improvement commonly reported after the procedure is performed may be due to diminished latissimus dorsi strength after transformation. The validity of both the original Sunagawa model and the previously proposed modification for dynamic cardiomyoplasty is further supported with these results. A nomogram methodology for predicting stroke volume after dynamic cardiomyoplasty for any particular patient is presented.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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